Physician uncertainty about value-based reforms could be due to insufficient understanding or engagement. (Image: jansucko/iStock/Getty Images Plus/Getty Images)

Most doctors don’t think that value-based payment models are the solution to cut healthcare costs and improve quality of care, according to a new survey.

The survey by Leavitt Partners found that physicians, employers and healthcare consumers all agree that fundamental changes are needed to make the country’s health system work better, but they don’t agree on how to accomplish that.

Physicians and employers also disagree on which payment reform efforts will work, who is responsible for driving reform and which are the most important barriers, the survey found.

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Relatively few physicians said accountable care organizations (ACOs) and bundled-payment models are the answer. Only 22% of the 621 physicians surveyed thought ACOs would lower spending, compared to nearly half of employer benefit decision-makers (48%). And 21% of physicians said bundled payments would work, while 46% of employers believe they can lower spending.

A study released late last year, however, found that while significant barriers still stand in the way of the transition to value-based reimbursement, physicians are getting more comfortable with new payment models.

In the new survey, there was more agreement on the cost-saving potential of price transparency tools and an increased emphasis on wellness and prevention. Just over half of physicians (52%) and employers (54%) say that better management of heavy users of healthcare and of behavioral and mental health would help curb costs.

“It is complicated to try to align incentives to solve cost problems when not all stakeholders see the cost problem in the same way,” said David Muhlestein, Leavitt Partners chief research officer, in a survey announcement.

When it comes to adopting provider payment reforms, the barrier overwhelmingly cited by physicians was the regulatory burden.

Physician uncertainty about value-based reforms could be due to insufficient understanding or engagement, the survey report said.

We released our surveys of consumers, employers and physicians on how they view the #healthcare system. They agree on some things, but there's also disagreement. #healthreform won't happen until the stakeholders align their interests or have a common pain. https://t.co/7AOHwCparJ

One revealing statistic concerned doctors’ familiarity with the Medicare Access and CHIP Reauthorization Act (MACRA), the Medicare payment system that took effect Jan. 1, 2017. Physicians were surveyed from June to July 2017, yet most (47%) said they recognized the name but were not familiar with MACRA requirements. Only 4% of physicians said they had an in-depth knowledge of the law and its requirements, and 13% had never heard of MACRA.